EMDR & Trauma-focused CBT
These are well-researched and established approaches to working with trauma or specifically, with post-traumatic stress disorder, including birth trauma. Both approaches aim to facilitate the brain’s natural attempts at processing the traumatic event or events, which gets blocked in PTSD.
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Usually, during a traumatic event, our brains help us survive it. The logical and complex thinking parts of the brain turn off and our survival response takes over - the fight, flight, freeze, flop or appease response (often just the fight and flight response is spoken about, but actually there are 5 responses). In the moment this is extremely helpful – imagine if a car was speeding toward you as you start to cross the road- you would want your body to jump back onto the pavement rather than dredge up GCSE physics calculations to try to estimate the actual speed and potential stopping distance.
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Once we are at a point of safety and the initial stress chemicals have reduced, the rest of our brain comes back online and tries to make sense of the event. We may do this in daytime or during our sleep.
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Most of the time our brains are able to manage this, perhaps over some time, and the emotional intensity of the memories decrease. We still know an awful thing happened to us, but we know it happened in the past and are no longer reacting physically as if we are under threat.
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In PTSD that natural process gets blocked- when we experience images or reminders of the event it triggers the same survival response that we had at the time of the event; stress chemicals are released and the part of the brain that we need to be able to make sense of the event and move it into long term memory gets switched off. Instead the event remains stored in fragments in our brain, each in its own neural network and when we experience an image or reminder of the event, our bodies react as if we are back in that moment again, needing to fight, flee, freeze, flop or appease.
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With PTSD it is usual to experience flashbacks, intrusive images, nightmares and/ or a re-experiencing of physical sensations felt at the time. There may be an obvious trigger, such as a intimate medical examination, other times it may seem to come up out of the blue. Many people experience anxiety, anger, irritability and a lot of distress alongside this and find that there are certain things that they no longer feel able to do. Difficulties with sleep, feeling anxious, easily startled or constantly alert, or the opposite, feeling disconnected or detached are also common experiences. You may also notice a shift in how you view yourself or others since the event.
In our sessions, our aim is to help the brain to process the event so that when you think about it, it feels like something unpleasant that happened in the past and no longer triggers the same strong feelings or sense that you are back there reliving it.
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If we are using trauma-focused CBT, we will make sense of your experience then and now, look for ‘hot spots’ – moments in the memory that keep recurring in flashbacks or hold significance in some way. Usually these will connect with feelings of fear, shame or disgust and perhaps with negative beliefs about yourself or others. Together we will seek to make sense of these and to update the hotspots. This bridges the gap between head and heart. For example, overcoming an experience where ‘Logically, I know now that I survived it but when I have that image I feel like I’m back there and about to die’
If we are using EMDR (eye movement desensitisation and reprocessing) we are aiming to unblock the processing by using bilateral stimulation alongside imagery. We may use eye movements, sounds or physical tapping – typically something called ‘butterfly taps’ which you do to yourself while holding an image in mind. Holding the image in mind alongside bilateral, or side-to-side, sensations seems to enable the brain to process the event. It is thought this may mimic what happens during Rapid Eye Movement (REM) sleep. We are also focussing on identifying and shifting any present focussed negative beliefs related to the event.
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We will consider both options together to decide which may be a good fit for you. EMDR can feel quite intense but can take effect quickly. Trauma-focussed CBT sometimes takes additional sessions but can be advantageous if you are wanting to work on one specific event and know there are other things in your history that you definitely want to leave alone, or if you just prefer a very clear, guided approach. In EMDR the structure of the session will feel quite predictable but we will aim to let your brain go wherever it needs to in order to heal, which can produce deep and lasting change but can feel a little more daunting for some. There are many things we can do to support you with this process though and we will speak about those in depth. The first part of EMDR treatment is all about preparing for it and building a stock of resources that you can draw upon during the processing, if needed.
""The essence of trauma is a disconnect from the self. Therefore the essence of healing is not just uncovering one’s past, but reconnecting with oneself in the present"
Gabor Mate
Want to know more?
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Please contact me if there's something you'd like to ask,
Or, book your free initial consultation to talk things through.
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